In Congenital Talipes Equinovarus (CTEV), the Pirani scoring system assesses 6 clinical signs: 3 hindfoot and 3 midfoot signs. Which of the following is a MIDFOOT Pirani sign?

• A Medial skin crease ✓
• B Posterior skin crease
• C Empty heel
• D Rigid equinus

Explanation

Pirani score (0–6 total, 0 = normal): Hindfoot signs (0–3): posterior skin crease, empty heel, rigid equinus. Midfoot signs (0–3): medial skin crease, curved lateral border of foot, talar head coverage (uncovering). Total score guides Ponseti casting — higher scores predict need for more casts. The Achilles tenotomy threshold is generally at persistent equinus after adequate correction of other components. Medial skin crease is specifically a midfoot sign reflecting cavus/adductus deformity.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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